A novel technique for removal of broken instrument from root canal in mandibular second molar.

The fracture of an endodontic instrument is an obstacle in completion of a routine successful pulp space therapy. Ni-Ti instruments corrode when in contact with sodium hypochlorite which leads to their deterioration and ultimately fracture during use. Removal of separated instrument from root canal is often a very difficult procedure. This procedure is more complicated when the instrument separated is closer to the mandibular canal. A case is presented in which a separated hand instrument was retrieved from the mesio buccal of a second molar approximating the mandibular canal root by replantation.

Effect of final irrigating solution on smear layer removal and penetrability of the root canal sealer.

OBJECTIVE: To evaluate the effect of final rinsing solution on smear layer removal through penetrability of the root canal sealer. MATERIALS AND METHODS: Each of the 30 teeth selected was decoronated and the root length standardized at 16 mm measured from the apex of the tooth to the cementoenamel junction (CEJ). A size 10-k file was used and working length was determined by subtracting 1mm from the measured length so that the length of the sample was 15mm. A combination of step back and crown down technique was done and apical portion was prepared till H-file no. 30. 3% NaOCl was used during cleaning and shaping of the canals. Finally the teeth were divided into three groups of 10 teeth each. Group-I was irrigated with 17% EDTA, Group-II with TUBLICID plus, and Group-III with Biopure MTAD(®). ISO 30 size gutta-percha points were selected as master cones. The Acroseal sealer was mixed with approximated concentration 0.1% fluorescent rhodamine B isothiocyanate dye. Obturation was done and after 48 hours, the roots were sectioned and subjected to confocal laser scanning microscopy. RESULTS: Comparisons among the three groups were done by two-way analysis of variance (ANOVA) and Newman-Keuls multiple post-hoc procedures. The two-way ANOVA showed statistically highly significant results. The maximum depth of sealer penetration was observed in Group II followed by Group III and Group I. CONCLUSION: The use of -Tubulicid plus as a final irrigant provided better smear layer removal than Biopure a mixture of doxicycline, citric acid and a detergent (Tween 80) (MTAD(®)) and 17% EDTA.

Antibacterial efficacy of sodium hypochlorite with a novel sonic agitation device.

OBJECTIVE: The aim of this study is to evaluate the antibacterial efficacy of 3% sodium hypochlorite (NaOCl) with sonic agitation devices. MATERIALS AND METHODS: Fifty extracted human single-rooted teeth were collected. Canals were prepared up to Profile #35/0.06. Forty teeth were inoculated with Enterococcus faecalis and incubated for 24 hours. The teeth were then divided into five groups based on the agitation device used. Group 1- was agitated with EndoActivator. Group 2 was agitated with Waterpik Power Flosser. In Group 3, Waterpik flosser was used with a nickel-titanium file. Group 4 (positive control) was not subjected to any agitation, and Group 5 -was the negative control. Superficial and deep dentinal shavings were collected from coronal and apical halves and sowed in brain heart infusion (BHI) agar to evaluate colony-forming units (CFU/mL). RESULTS: Krusal Wallis, analysis of variance (ANOVA) and Mann-Whitney U test showed that Group 3 showed a smaller number of CFUs/mL Group 2 showed a relatively greater number of CFU/mL. The deep apical dentin areas showed more number of CFUs relative to other sites. CONCLUSION: The nickel-titanium file attached to the Waterpik Power Flosser system was found to be as effective as the EndoActivator in antibacterial efficacy against E.faecalis.

Assessment of precipitate formation on interaction of irrigants used in different combinations: an in vitro study.

INTRODUCTION: Irrigants play an essential role in the successful debridement and disinfection of pulp space. Various combination of irrigants used during root canal treatment enhance their efficacy, but some form precipitates which affects the diffusion of intracanal medicaments and the seal of the obturated root canal. AIM: To evaluate the combination of various irrigants whether it forms the precipitate and also to quantify the amount of precipitate formed. MATERIALS AND METHODS: Five different irrigants were taken in ten test tubes each having the combination of two irrigants and observed for 2 min for precipitate formation. RESULTS: One-way-ANOVA test revealed more amounts of precipitate with 2% Chlorhexidine (CHX) 5% Tulsi followed by 2% CHX, 5% Neem and 3% Sodium hypochlorite 2% CHX. CONCLUSION: Precipitate formation is seen more with the 2% CHX-5% Neem followed by 2% CHX-5% Tulsi when compared with the control group. When these combinations of irrigants were used, intermediate flushes of saline or distilled water reduced the amount of precipitate.

Endodontic retreatment--unusual anatomy of a maxillary second and mandibular first premolar: report of two cases.

An accurate diagnosis of the morphology of the root canal system is a prerequisite for successful root canal treatment. A major cause of endodontic treatment failure in missed (or) untreated root canals is that they still harbor infection. Careful radiographic interpretation and examination of pulp chamber floors are helpful in locating root canal entrances. These case reports present anatomical variations in upper and lower premolars.

Dentinal hypersensitivity: A comparative clinical evaluation of CPP-ACP F, sodium fluoride, propolis, and placebo.

BACKGROUND: Dentine hypersensitivity is a transient condition that often resolves with the natural sclerotic obturation of dentinal tubules. A potent topically applied in-office desensitizing treatment is indicated as the choice of treatment when dentine hypersensitivity is localized to one or two teeth. AIM: The present study aimed to evaluate and compare the clinical efficiency of CPP-ACP F, sodium fluoride, propolis, and distilled water that was used as placebo in treating dentinal hypersensitivity. MATERIALS AND METHODS: 120 patients aged 20-40 years reporting with dentinal hypersensitivity in relation to canine, premolar and molars with erosion, abrasion, and gingival recession were randomly assigned to four groups of 30 patients each. Response to air jet and tactile stimuli were measured using visual analogue scale initially on 1st, 7th, 15th, 28th, 60(th), and final assessment was done on the 90th day. STATISTICAL ANALYSIS: A statistical analysis was done using Anova test (Fischer's test) and Tukey HSD test for multicomparison. RESULTS: The teeth treated with the test group showed decrease in the mean hypersensitivity values compared to control group, over a period of three months. The results showed propolis to be most efficient in treating dentinal hypersensitivity and CPP- ACPF showed to be the least efficient. CONCLUSION: All test groups were effective in reducing dentinal hypersensitivity, although they differed in rapidity of action over the period of 3 months. Further studies can be done using advanced materials and techniques. Multiple therapeutic modalities have been developed to treat dentinal hypersensitivity including products that impede nerve conduction of pain stimulus, products that mechanically occlude dentinal tubules, and calcium containing products designed to create plugs in the tubules utilizing a demineralization mechanism.